{include file='1_header_footer/header_no_login.html'}

<h1>Anmeldung</h1>
   <form class="c-form" action="" method="post">

            <fieldset id="personal">

               <legend>Persönliche Daten</legend>
               <!--<div id="subject-fragen">
                    <label for="recherche-fragen" class="vip">Ich habe diese Fragen: <em>*</em></label>
                    <textarea name="recherche-fragen" id="recherche-fragen" tabindex="2" cols="20" rows="4"></textarea>

                </div>-->
               <ol>
                <li>
                    <label for="vorname" class="vip">Vorname <em>*</em></label>
                    <input name="vorname" id="vorname" tabindex="1" value="" />
                </li>
                <li>
                    <label for="name" class="vip">Nachname <em>*</em></label>

                    <input name="name" id="name" tabindex="2" value="" />
                </li>
                <li class="two-elements" id="anschrift">
                    <p>Straße / Haus Nr.</p>
                    <div>
                         <label class="od" for="strasse"> Straße </label>
                         <input name="strasse" id="strasse" tabindex="3" value="" />

                         <label for="hNr">Haus Nr.</label>
                         <input name="hNr" id="hNr" tabindex="4" value="" />
                    </div>
                </li>

                <li class="two-elements" id="ortinfo">
                    <p>PLZ / Ort</p>
                    <div>
                         <label for="plz">PLZ/</label>
                         <input name="plz" id="plz" tabindex="5" value="" />
                         <label for="ort">Ort</label>
                         <input name="ort" id="ort" tabindex="6" value="" />
                    </div>
                </li>
                <li>
                    <label for="land" class="vip">Land <em>*</em></label>
                    <select name="land" id="land" tabindex="7">
                        <option value="DE">Deutschland</option>
                        <option value="AT">Österreich</option>
                        <option value="CH">Schweiz</option>
                        <option value="LI">Lichtenstein</option>
                    </select>
                </li>
                <li>
                    <label for="email" class="vip">E-Mail <em>*</em></label>
                    <input name="email" id="email" tabindex="8" value="@" />
                </li>
                <li class="two-elements" id="telefon">
                    <p>Telefon(+49/---/---)</p>

                    <div>
                         <label for="lv">Landesvorwahl/</label>
                         <input name="lv" id="lv" tabindex="9" value="" />
                         <label for="ov">Ortsvorwahl</label>
                         <input name="ov" id="ov" tabindex="10" value="" />
                         <label for="rn">Rufnummer</label>
                         <input name="rn" id="rn" tabindex="11" value="" />
                    </div>
                </li>
              </ol>
            </fieldset>

            <p id="vip-desc"><em>*</em> Pflichtfelder</p>

             <div id="myButton">
                 <input value="Senden" type="submit" />
            </div>
          </form>

{$register.name}

{include file='1_header_footer/footer_no_login.html'}
